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Sadri BS, Low DW, Jackson OA, Jackson BM, Belkin N. Subclavian to carotid artery bypass for a case of ocular ischemic syndrome. Vascular 2023:17085381231164015. [PMID: 36917226 DOI: 10.1177/17085381231164015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
BACKGROUND Ocular Ischemic Syndrome (OIS) is a rare, vision threatening condition associated with severe carotid artery disease. There are few cases of OIS reported in the literature. METHODS We present the case of a 54-year-old male with history of multiple previous carotid interventions including a right carotid stent, who presented with right-sided OIS. RESULTS CTA and angiogram showed a severe calcific plaque causing restenosis of the right carotid stent, with a patent right internal carotid artery (ICA) in the very distal neck. The right common carotid artery (CCA) was patent but diseased with ulcerated plaque extending proximally to below the level of the clavicle. The left CCA was chronically occluded from its origin all the way to the bifurcation. Given our patient's surgical history, the imperative to revascularize the ipsilateral carotid, and a diffusely diseased ipsilateral CCA, he was successfully treated with an ipsilateral subclavian to internal carotid bypass. CONCLUSION There is paucity of data regarding the best approach for carotid revascularization in OIS. This case report discusses our unique perioperative decision making as well as relevant literature.
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Affiliation(s)
- Babak S Sadri
- Department of Surgery, 1147Lehigh Valley Hospital, Allentown, PA, USA
| | - David W Low
- Division of Plastic Surgery, 21798Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Oksana A Jackson
- Department of Surgery, Division of Plastic, Reconstructive and Oral Surgery, 6567The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Nathan Belkin
- Division of Plastic Surgery, 21798Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Gunna NT, Paritala A, Takkar B, Sheth J. Ocular ischaemic syndrome following coil embolisation for direct carotid cavernous fistula. BMJ Case Rep 2021; 14:14/5/e242121. [PMID: 34045204 DOI: 10.1136/bcr-2021-242121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 36-year-old man presented with proptosis and external ophthalmoplegia of the left globe following road traffic injury. Cerebral angiogram revealed moderate flow direct carotid cavernous fistula on left side for which coil embolisation was done repeatedly. Subsequently, the patient developed decreased vision in left eye and developed features of left-sided ocular ischaemic syndrome. The patient was treated conservatively with spontaneous reversal of ocular ischaemic syndrome and complete regain of visual function.
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Affiliation(s)
- Nithin Teja Gunna
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anusha Paritala
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Brijesh Takkar
- Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India .,Indian Health Outcomes, Public Health and Economics Research (IHOPE) Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Jenil Sheth
- Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Qin Y, Ji M, Deng T, Luo D, Zi Y, Pan L, Wang Z, Jin M. Functional and morphologic study of retinal hypoperfusion injury induced by bilateral common carotid artery occlusion in rats. Sci Rep 2019; 9:80. [PMID: 30643163 PMCID: PMC6331588 DOI: 10.1038/s41598-018-36400-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022] Open
Abstract
Retinal hypoperfusion injury is the pathophysiologic basis of ocular ischemic syndrome (OIS) which often leads to severe visual loss. In this study, we aimed to establish a rat model of retinal chronic hypoperfusion by bilateral common carotid artery occlusion (BCCAO) and observe changes in the retinal function and morphology. We found that model rats showed retinal arteriosclerosis, slight dilated retinal vein, small hemangiomas, hemorrhages, vascular segmental filling, and nonperfused areas after 2 weeks of BCCAO. In the model rats, the retinal circulation time was significantly prolonged by fluorescein fundus angiography (FFA), the latency of a and b waves was delayed and the amplitude was decreased significantly at each time point by electroretinogram (ERG), and the perfusion of the eyes continued to reduced. Morphologic and ultrastructural changes covered that the retinal ganglion cells (RGCs) presented obvious apoptosis and the thickness in the retinal layers were significantly thinner. Collectively, these findings suggested that BCCAO induced retinal hypoperfusion injury in the model rats, thus providing an ideal animal model for the study of OIS.
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Affiliation(s)
- Yali Qin
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Meiqi Ji
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Tingting Deng
- Clinical Medical Research Institute, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Dan Luo
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yingxin Zi
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Lin Pan
- Clinical Medical Research Institute, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Zhijun Wang
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Ming Jin
- Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, 100029, China.
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Furino C, Guerriero S, Boscia F, Micelli Ferrari T, Nicola C, Sborgia L, Sborgia C. In Vivo Evidence of Hypotrophic Ciliary Body in Ocular Ischemic Syndrome by Ultrasound Biomicroscopy. Ophthalmic Surg Lasers Imaging Retina 2007; 38:505-7. [DOI: 10.3928/15428877-20071101-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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